High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

Abstract

Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Diagnosis is difficult at birth without neonatal screening. Neonatal thyroid screening was established in Prilep, Republic of Macedonia as an integral part of the nationwide screening program. To estimate the prevalence of CH in this region, neonatal thyroid screening was performed on 9757 newborns, during the period 2002–2011. The DELFIA method was applied to measure the thyroid-stimulating hormone (TSH) concentration in dried blood spot samples on standard filter paper taken 48 hours after birth by heel-stick. The TSH cut-off level was 10 mU/L.The neonatal thyroid screening coverage was 93.4%. Eight newborns with CH were detected, with an incidence of 1:1220 live births, significantly higher compared to the nationwide results 1:2602. The TSH level was not significantly dependent on the gender of the newborn. There was a statistically significant difference between the TSH level and the timing of newborn screening sampling (p <0.05) and between the TSH level and the newborn birth weight (p = 0.01). One point ninety-two percent of newborns with TSH levels above 5 mU/L indicated an iodine sufficiency in Prilep. The incidence of CH in Prilep, which is higher when compared with that reported in surrounding countries, might be a consequence of the higher percentage of the Romany population in this region. Further analysis of this population in other regions is warranted.

Risk factors associated with congenital hypothyroidism: a case-control study in southeast Iran

“…The study results showed that boys were at higher risk of CH than girls. Anastasovska et al concluded that the risk of CH was higher among boys ( 15 ). Many reports have indicated that CH is frequently found in girls ( 16 , 17 ).…”

Neonatal thyroid screening a tertiary care experience at VSS Medical College and Hospital, Burla

“…The recall rate in other studies were 0.18% (Anastasvska et al, Macedonia), 1.83% (Manglik et al, Kolkata), 31.9% (Raj et al, Kerala). 4,11,15 16 There were no dropouts observed. The reason for no dropout in our study may be due to the reason that our hospital being the only tertiary care centre for surrounding districts of Odisha.…”

“…In our study out of 3 newborns were diagnosed to have congenital hypothyroidism out of 2212 screened newborns, in which 2 were male and 1 was female, indicating male preponderance with male to female ratio 2:1, this finding is supported by few studies carried out previously which reports male to female ratio with male preponderance like Anjum et al (1.1:1, Pakistan), Anastasovska et al (1.6:1, Macedonia). 10,11 Two studies Ittihad et al in Iraq (6949 neonates) and Arash et al in Iran during 1998-2005, reported higher incidence of hypothyroidism in newborns born by vaginal delivery than LSCS. 12,13 In our study 2 neonates were born out of vaginal delivery (VD) and 1 by caesarean delivery (CD), but our study being of small sample size and by matter of fact that vaginal delivery is preferred choice of delivery in majority of pregnancies.…”

Neonatal Screening for Congenital Hypothyroidism in Duhok Governorate (Iraq); A Preliminary Study

“…These varying recall rates are attributable to several factors, such as the use of T4 or TSH level or both for screening, differences in sample collection methods and analysis procedures in different laboratories, and differences in recall criteria, which are related to the cultural regional and social factors of a country 3 . It may also reflect the levels of iodine deficiency in different regions 21 . the factors associated with congenital hypothyroidism in this study were prematurity, thyroid disease of the mother and congenital anomalies.…”